title: Retrospective analysis of antimicrobial resistance and bacterial spectrum of infection in Gabon, Central Africa.
abstract: BACKGROUND
  Physicians depend on reliable information on the local epidemiology of infection and antibiotic resistance rates to guide empiric treatment in critically ill patients. As these data are scarce for Central Africa, we performed a retrospective analysis of microbiological findings from a secondary care hospital in Gabon.
  
  
  METHODS
  Microbiological reports from 2009 to 2012 were used to assess the non-susceptibility rates of the three most common isolates from six major types of infections (bloodstream, ear-eye-nose-throat, surgical site, skin and soft tissue, urinary tract and wound infection).
  
  
  RESULTS
  A high diversity of pathogens was found, but Staphylococcus aureus was predominant in the majority of infections. Overall, the three most prevalent pathogens in children were S. aureus (33.7%), Streptococcus pyogenes (8.1%) and Escherichia coli (4.5%) and in adults S. aureus (23.5%), E. coli (15.1%) and Klebsiella pneumoniae (7.4%). In total, 5.8% (n = 19) of all S. aureus isolates were methicillin resistant. The proportion of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae was 15.4% (n = 78), 49.4% of all K. pneumoniae were ESBL-producer (n = 42).
  
  
  CONCLUSIONS
  The high diversity of potential pathogens and high resistance rates in Gram-negative bacteria challenge a rational empiric use of antibiotics. Countrywide continuous sentinel surveillance is therefore urgently needed.
authors.affiliation: Centre de Recherche Médicale de Lambaréné (CERMEL), Lambaréné, Gabon. frieder.schaumburg@ukmuenster.de.
authors.forename: Abraham S
authors.initials: AS
authors.lastname: Alabi
authors.forename: Lisa
authors.initials: L
authors.lastname: Frielinghaus
authors.forename: Harry
authors.initials: H
authors.lastname: Kaba
authors.forename: Katrin
authors.initials: K
authors.lastname: Kösters
authors.forename: Michaëla A M
authors.initials: MA
authors.lastname: Huson
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Kahl
authors.forename: Georg
authors.initials: G
authors.lastname: Peters
authors.forename: Martin P
authors.initials: MP
authors.lastname: Grobusch
authors.forename: Saadou
authors.initials: S
authors.lastname: Issifou
authors.forename: Peter G
authors.initials: PG
authors.lastname: Kremsner
authors.forename: Frieder
authors.initials: F
authors.lastname: Schaumburg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D005681:Gabon / Q000453:epidemiology; D006090:Gram-Negative Bacteria / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult